Weight Loss Medicine
Dr. Rubina Baig discusses the different weight loss medications and the benefits and risks.
Featured Speaker:
Rubina Baig, DO
Dr. Rubina Baig joins Riverside with vast knowledge and expertise in her field. Dr. Baig completed her Doctor of Medicine at Ross University School of Medicine in Dominica, West Indies. She recently completed her Family Medicine Residency at Western Michigan University Home Stryker MD School of Medicine in Kalamazoo, MI. Dr. Baig is board-eligible in family medicine. In addition to her education, Dr. Baig is a member of the American Academy of Family Physicians and the American Medical Association. She is proficient in English and Hindi/Urdu. Dr. Baig will be seeing patients at Riverside's Healthcare Frankfort Campus by appointment, walk-ins welcome. Transcription:
Weight Loss Medicine
Intro: Riverside Healthcare, puts the health and wellness information you need well within reach.
Host: Today, we're going to be talking with Dr. Rubina Baig. She is a family medicine provider at our Frankfort Campus. Dr. Baig, thank you so much for joining us today.
Dr. Rubina Baig: Thank you for having me.
Host: So let's start off a little bit by telling our audience a little bit about you. what. Brought you into medicine?
Dr. Rubina Baig: So I went into medicine because I had an interest since I was a kid to improve the health of people in a large scale. I had a lot of good influences growing up. I had a family medicine doctor who took care of my family. I grew an interest for preventative medicine especially, just seeing how people might go into the hospital for very trivial reasons. And if they just had a good relationship with our family medicine doctor, things could have been prevented.
And that kind of ties into my interest in weight loss medicine too. Kind of preventing weight gain and preventing obesity can keep a lot of people healthy and out of the hospital and give them a good quality of life. And so those are all the reasons I went into medicine.
Host: Okay. And that's very fitting because our topic today is focused on weight loss medicine and more specifically on managing your weight loss with the support of your primary physician. So obesity and being overweight is sadly a very common health problem in the United States. Is there a difference between somebody who's obese and somebody who's just overweight?
Dr. Rubina Baig: So those are two actual categories that are separate. So we classify it based on BMI. So BMI between 18.5 and around 25 is normal BMI. And between 25 and 30 is considered overweight. And then anything above 30 is considered obesity. We do also say that BMI 40 and up is severe obesity.
Host: Okay. Does your built or anything have anything to do with your BMI because I know that can be based built.
Dr. Rubina Baig: That's a really good question. And the big controversy with BMI is that it's not supposed to be one-size or one-measurement-fits-all. So yeah, some people have a bigger build. Some athletes have more muscle mass. So BMI is not perfect. It's just a clue. It's really easy to measure. You get it every time you visit your doctor. And so we kind of use it as a guide. But you're absolutely right, it's not always reliable.
Another clue we can use is the waistline, that kind of gives us an idea of abdominal mass. And there are other ways to measure body fat, but BMI is just the one we more commonly use.
Host: Okay. And so obesity and being overweight, is this something that is linked to genetics at all?
Dr. Rubina Baig: It can be. We see about 40 to 50% can be linked to genetics. It's not just one gene, but it's really multifactorial. But we do think more of it comes from behaviors, learned behaviors and your environment. So kind of when you were growing up, what foods you were used to eating, where you live. Are there healthy grocery stores nearby or is it more fast food restaurants? There are a lot of other factors. So we'll try to let patients know that genetics does not mean it's your destiny.
Host: Well, that's very encouraging because I know a lot of people are like, "Oh well, that's just the way I am." But it is something that could be reversed. If it's a learned behavior especially, it's something maybe challenging to relearn, but it's something that could be reversed
Dr. Rubina Baig: Yeah, definitely. I try to tell patients that it is very difficult. There might be things that are working against you. It might be a little bit of an uphill battle. But yeah, there are things we can work on. Correcting certain mentalities, certain thought processes, breaking any myths. And yeah, your doctors are always here to help you, you know, to talk through diet, exercise. There are other things, medications, referrals we can make. There's no reason to ever give up.
Host: So are there other health problems or things that being overweight could cause?
Dr. Rubina Baig: Yeah, actually there's two different categories of health problems. So one category is more on the hormonal side and one is more on the body mass side. So the hormonal side, weight gain can lead to pre-diabetes, diabetes, metabolic syndrome, high blood pressure, heart disease, high cholesterol, abnormal periods, fertility, skin problems, a lot of different things in a hormonal sense.
The addition of weight to your body means more of a burden that you have to carry and it can actually compress certain parts of the body. So you can end up with gastric reflux and you can get sleep apnea, some breathing problems, knee pain, joint pain, et cetera. And the other category, although weight gain is not directly correlated they have noticed that people who tend to lose weight or on the lower side of the weight spectrum have a significantly better chance of fighting off about 50 to 20 different cancers. So there's a lot more benefit with losing weight and avoiding all of these medical problems.
Host: Definitely, if it's something you can avoid, definitely something you can work on. So when a patient comes in to you overweight or obese, what is your approach? Where do you start?
Dr. Rubina Baig: The first thing we do is education. Before the education part, I do kind of clarify what their diet is like and what their activity regimen is like, just to see where we're starting from. So when I look at diet, we definitely talk about carbohydrates. I think that's just the easiest way to go. I feel like our American diet is filled with carbs. And so we get an idea of where we're starting from and then I go into the education. Kind of telling them what carbohydrates are, which foods are highest in carbohydrates.
And then we find out places where there can be improvement, so ways to cut down carbohydrates, taking out bread, pasta, rice, potatoes, cutting out sugars such as soda or juice. And then also taking a look at how active they are. So if they're sitting down most of the day or laying down, being sedentary can lead to faster weight gain. So trying to find ways, fun ways, to keep them active at least three or four times a week doing like an hour or even 30 minutes of exercise. And both of those things can lead to some progress actually at the very beginning of our weight loss plan
Host: Yeah. I can definitely see how that could work. Even just those small changes can make a big difference or at least getting it started too. It may not fix everything, but at least gets you started down the right path. And "I can do this," gives you a little confidence.
Dr. Rubina Baig: Definitely, people realize a lot of things. They say, "Well, doc, I realize I'm eating out of boredom" or "I was just trying to finish off the food. I cooked too much and I didn't want it to go to waste." So people are definitely finding a lot of realizations just from our first visit.
Host: So there are times when an additional intervention is probably needed. Are there medications or next steps that you look to when that is the case?
Dr. Rubina Baig: Yeah. So after we have melt all we can from fixing the diet and adding in physical activity, we do look at some medications. Some of the classes of medications that I look at are stimulants, which they work as an appetite suppressant. So one of those meds is phentermine. There's another medication called Topamax. It's usually a migraine med. There's another med called Saxenda, which is actually a replica of a diabetes medication. There's Welbutrin, naltrexone.
These are all meds that somehow work with the human body and they kind of alter the hormones so that you have less hunger hormones and more fullness hormones. And these meds can also be combined into combination pills. But we try to do as much as we can with diet and exercise and then use medications as a last resort. And I do tell patients that you still have to make diet changes and then the medications will work. If you make zero diet changes, the medications do nothing.
Host: Oh yeah, most definitely. I know just having that thought of, "Oh well, my doctor's putting me on these medications. This is going to help." Like, "Well, no. You have to know that you're going to change and actually put your mind to it," so that your mind has a lot to do with that. Additionally to medications, there is weight loss surgery. Is that ever recommended or how would you approach that?
Dr. Rubina Baig: So bariatric surgery, I usually think of a patient who has a BMI of 40 or above. So that's already the severe obesity range. And I do tell those patients straight away that they do qualify. Having a BMI of 40, there's probably some genetics associated or some things working against them that would make them a good candidate to have bariatric surgery right off the bat. And I think the idea behind that is getting them bariatric surgery sooner than later will help that population of patients avoid severe consequences such as medical conditions that could help them have a healthier life sooner than later.
Host: Well, if someone is overweight or can't seem to lose weight on their own because I know a lot of people, you try to lose weight on your own and you just need that additional assistance, somebody who can boost your confidence, help give you ideas, those kind of things. What would their set be? Would they schedule an appointment with you or with a provider? Or what would you recommend?
Dr. Rubina Baig: Yeah. So if someone's already been trying their best to lose weight and they just are hitting a wall and they come to see me, I tell them that there's still always something we can do. And of course, seeing your doctor is a great first step. But we always go back to step one, which is the diet. So if you've been trying to eat healthy and choose wisely, I would still say carb tracking, really getting nitty and gritty with the foods and understanding where your shortcomings are, continuing to stay consistent with exercise. I think consistency is key more than intensity and that's good to find things you enjoy. You just don't want to be miserable doing all of this. You want to make it sustainable. We're not trying to find a fad diet or an exercise trend. We're trying to build a lifestyle for you.
If those don't work, there are many apps out there for diet and exercise. So finding something that can be fun to use and assist you. Making a vision board, sometimes you need a visual, a goal to look forward to and goal tracking, writing things down is very helpful to inspire you. And just talking to your doctor, whether it's going to be a medication or referral, surgery, whether time to start medications, your doctor can always help guide you and help you, morally support you and get you to that next step. But there are so many newer devices and surgeries and innovations in the field of obesity medicine. And I just want patients to know that there's no reason to give up.
Host: Well, if you are someone who is looking for just some added assistance or needed a primary care provider, step one, just call your doctor. Let them know what you're going through. Give them a call. If you don't have a primary care provider, Riverside does have a referral line, (855) 404-3627. They'll be able to find somebody who's close to home or in the area of what you're looking for. Any of our specialties, specialists, primary care providers are on there. You can also schedule an appointment online at riversidehealthcare.org or you can schedule through MyRiverside MyChart. So Dr. Baig, is there anything else that you wanted to mention that we may have missed?
Dr. Rubina Baig: Yes, there is. I do want to mention that there are so many ways with diet. As far as carb tracking and minimizing carbs, there are people who do calorie-restricted diets too. There's also intermittent fasting out there. All these methods, there are apps to help you track everything whether it's carbs, calories, keeping a timer on your intermittent fast. There are also maybe 20 plus different types of intermittent fast. People utilize other methods like portion control, meal replacements. There are a lot of methods out there, but I felt that carb tracking and carb restriction is the easiest one that I start with for my patients.
If anyone needs a resource to look for healthy recipes or just some guides and information that is reliable, they can use dietdoctor.com. It is a website created by doctors. As far as exercise. It is very difficult to fit in exercise in today's day. We are all workaholics and we have very hectic work schedules. A lot of people have to manage a home, taking care of the kids, sending them to school
And so instead of having to go to a gym, there are many methods to do exercise at home. There's a lot of free content on YouTube. I do even tell sometimes my kids and teenagers too practice a TikTok dance. There are many phone apps with free content and you can always subscribe and get some paid versions and you do get what you pay for, so you can always invest in yourself and get more ideas for exercise. You can get a gym membership and, of course, go safely. And you can also get very affordable workout gear. Sometimes at the $5 store, you can get weights, you can get jump rope, resistance bands or yoga mats. As long as it's something that you enjoy doing, I think that's all that matters.
Host: Most definitely. Your health is definitely your greatest asset, so make sure you're taking care of yourself. And If you are just needing that extra support, give your primary care provider a call. They're here. They're very knowledgeable. They want to help you and they can maybe give you some additional information that you maybe haven't seen somewhere else.
So thank you so much for joining me today, Dr. Baig. And thank you so much for tuning in to the Well Within Reach podcast. To learn more about this topic and various topics we have, our website is RiversideHealthcare.org.
Weight Loss Medicine
Intro: Riverside Healthcare, puts the health and wellness information you need well within reach.
Host: Today, we're going to be talking with Dr. Rubina Baig. She is a family medicine provider at our Frankfort Campus. Dr. Baig, thank you so much for joining us today.
Dr. Rubina Baig: Thank you for having me.
Host: So let's start off a little bit by telling our audience a little bit about you. what. Brought you into medicine?
Dr. Rubina Baig: So I went into medicine because I had an interest since I was a kid to improve the health of people in a large scale. I had a lot of good influences growing up. I had a family medicine doctor who took care of my family. I grew an interest for preventative medicine especially, just seeing how people might go into the hospital for very trivial reasons. And if they just had a good relationship with our family medicine doctor, things could have been prevented.
And that kind of ties into my interest in weight loss medicine too. Kind of preventing weight gain and preventing obesity can keep a lot of people healthy and out of the hospital and give them a good quality of life. And so those are all the reasons I went into medicine.
Host: Okay. And that's very fitting because our topic today is focused on weight loss medicine and more specifically on managing your weight loss with the support of your primary physician. So obesity and being overweight is sadly a very common health problem in the United States. Is there a difference between somebody who's obese and somebody who's just overweight?
Dr. Rubina Baig: So those are two actual categories that are separate. So we classify it based on BMI. So BMI between 18.5 and around 25 is normal BMI. And between 25 and 30 is considered overweight. And then anything above 30 is considered obesity. We do also say that BMI 40 and up is severe obesity.
Host: Okay. Does your built or anything have anything to do with your BMI because I know that can be based built.
Dr. Rubina Baig: That's a really good question. And the big controversy with BMI is that it's not supposed to be one-size or one-measurement-fits-all. So yeah, some people have a bigger build. Some athletes have more muscle mass. So BMI is not perfect. It's just a clue. It's really easy to measure. You get it every time you visit your doctor. And so we kind of use it as a guide. But you're absolutely right, it's not always reliable.
Another clue we can use is the waistline, that kind of gives us an idea of abdominal mass. And there are other ways to measure body fat, but BMI is just the one we more commonly use.
Host: Okay. And so obesity and being overweight, is this something that is linked to genetics at all?
Dr. Rubina Baig: It can be. We see about 40 to 50% can be linked to genetics. It's not just one gene, but it's really multifactorial. But we do think more of it comes from behaviors, learned behaviors and your environment. So kind of when you were growing up, what foods you were used to eating, where you live. Are there healthy grocery stores nearby or is it more fast food restaurants? There are a lot of other factors. So we'll try to let patients know that genetics does not mean it's your destiny.
Host: Well, that's very encouraging because I know a lot of people are like, "Oh well, that's just the way I am." But it is something that could be reversed. If it's a learned behavior especially, it's something maybe challenging to relearn, but it's something that could be reversed
Dr. Rubina Baig: Yeah, definitely. I try to tell patients that it is very difficult. There might be things that are working against you. It might be a little bit of an uphill battle. But yeah, there are things we can work on. Correcting certain mentalities, certain thought processes, breaking any myths. And yeah, your doctors are always here to help you, you know, to talk through diet, exercise. There are other things, medications, referrals we can make. There's no reason to ever give up.
Host: So are there other health problems or things that being overweight could cause?
Dr. Rubina Baig: Yeah, actually there's two different categories of health problems. So one category is more on the hormonal side and one is more on the body mass side. So the hormonal side, weight gain can lead to pre-diabetes, diabetes, metabolic syndrome, high blood pressure, heart disease, high cholesterol, abnormal periods, fertility, skin problems, a lot of different things in a hormonal sense.
The addition of weight to your body means more of a burden that you have to carry and it can actually compress certain parts of the body. So you can end up with gastric reflux and you can get sleep apnea, some breathing problems, knee pain, joint pain, et cetera. And the other category, although weight gain is not directly correlated they have noticed that people who tend to lose weight or on the lower side of the weight spectrum have a significantly better chance of fighting off about 50 to 20 different cancers. So there's a lot more benefit with losing weight and avoiding all of these medical problems.
Host: Definitely, if it's something you can avoid, definitely something you can work on. So when a patient comes in to you overweight or obese, what is your approach? Where do you start?
Dr. Rubina Baig: The first thing we do is education. Before the education part, I do kind of clarify what their diet is like and what their activity regimen is like, just to see where we're starting from. So when I look at diet, we definitely talk about carbohydrates. I think that's just the easiest way to go. I feel like our American diet is filled with carbs. And so we get an idea of where we're starting from and then I go into the education. Kind of telling them what carbohydrates are, which foods are highest in carbohydrates.
And then we find out places where there can be improvement, so ways to cut down carbohydrates, taking out bread, pasta, rice, potatoes, cutting out sugars such as soda or juice. And then also taking a look at how active they are. So if they're sitting down most of the day or laying down, being sedentary can lead to faster weight gain. So trying to find ways, fun ways, to keep them active at least three or four times a week doing like an hour or even 30 minutes of exercise. And both of those things can lead to some progress actually at the very beginning of our weight loss plan
Host: Yeah. I can definitely see how that could work. Even just those small changes can make a big difference or at least getting it started too. It may not fix everything, but at least gets you started down the right path. And "I can do this," gives you a little confidence.
Dr. Rubina Baig: Definitely, people realize a lot of things. They say, "Well, doc, I realize I'm eating out of boredom" or "I was just trying to finish off the food. I cooked too much and I didn't want it to go to waste." So people are definitely finding a lot of realizations just from our first visit.
Host: So there are times when an additional intervention is probably needed. Are there medications or next steps that you look to when that is the case?
Dr. Rubina Baig: Yeah. So after we have melt all we can from fixing the diet and adding in physical activity, we do look at some medications. Some of the classes of medications that I look at are stimulants, which they work as an appetite suppressant. So one of those meds is phentermine. There's another medication called Topamax. It's usually a migraine med. There's another med called Saxenda, which is actually a replica of a diabetes medication. There's Welbutrin, naltrexone.
These are all meds that somehow work with the human body and they kind of alter the hormones so that you have less hunger hormones and more fullness hormones. And these meds can also be combined into combination pills. But we try to do as much as we can with diet and exercise and then use medications as a last resort. And I do tell patients that you still have to make diet changes and then the medications will work. If you make zero diet changes, the medications do nothing.
Host: Oh yeah, most definitely. I know just having that thought of, "Oh well, my doctor's putting me on these medications. This is going to help." Like, "Well, no. You have to know that you're going to change and actually put your mind to it," so that your mind has a lot to do with that. Additionally to medications, there is weight loss surgery. Is that ever recommended or how would you approach that?
Dr. Rubina Baig: So bariatric surgery, I usually think of a patient who has a BMI of 40 or above. So that's already the severe obesity range. And I do tell those patients straight away that they do qualify. Having a BMI of 40, there's probably some genetics associated or some things working against them that would make them a good candidate to have bariatric surgery right off the bat. And I think the idea behind that is getting them bariatric surgery sooner than later will help that population of patients avoid severe consequences such as medical conditions that could help them have a healthier life sooner than later.
Host: Well, if someone is overweight or can't seem to lose weight on their own because I know a lot of people, you try to lose weight on your own and you just need that additional assistance, somebody who can boost your confidence, help give you ideas, those kind of things. What would their set be? Would they schedule an appointment with you or with a provider? Or what would you recommend?
Dr. Rubina Baig: Yeah. So if someone's already been trying their best to lose weight and they just are hitting a wall and they come to see me, I tell them that there's still always something we can do. And of course, seeing your doctor is a great first step. But we always go back to step one, which is the diet. So if you've been trying to eat healthy and choose wisely, I would still say carb tracking, really getting nitty and gritty with the foods and understanding where your shortcomings are, continuing to stay consistent with exercise. I think consistency is key more than intensity and that's good to find things you enjoy. You just don't want to be miserable doing all of this. You want to make it sustainable. We're not trying to find a fad diet or an exercise trend. We're trying to build a lifestyle for you.
If those don't work, there are many apps out there for diet and exercise. So finding something that can be fun to use and assist you. Making a vision board, sometimes you need a visual, a goal to look forward to and goal tracking, writing things down is very helpful to inspire you. And just talking to your doctor, whether it's going to be a medication or referral, surgery, whether time to start medications, your doctor can always help guide you and help you, morally support you and get you to that next step. But there are so many newer devices and surgeries and innovations in the field of obesity medicine. And I just want patients to know that there's no reason to give up.
Host: Well, if you are someone who is looking for just some added assistance or needed a primary care provider, step one, just call your doctor. Let them know what you're going through. Give them a call. If you don't have a primary care provider, Riverside does have a referral line, (855) 404-3627. They'll be able to find somebody who's close to home or in the area of what you're looking for. Any of our specialties, specialists, primary care providers are on there. You can also schedule an appointment online at riversidehealthcare.org or you can schedule through MyRiverside MyChart. So Dr. Baig, is there anything else that you wanted to mention that we may have missed?
Dr. Rubina Baig: Yes, there is. I do want to mention that there are so many ways with diet. As far as carb tracking and minimizing carbs, there are people who do calorie-restricted diets too. There's also intermittent fasting out there. All these methods, there are apps to help you track everything whether it's carbs, calories, keeping a timer on your intermittent fast. There are also maybe 20 plus different types of intermittent fast. People utilize other methods like portion control, meal replacements. There are a lot of methods out there, but I felt that carb tracking and carb restriction is the easiest one that I start with for my patients.
If anyone needs a resource to look for healthy recipes or just some guides and information that is reliable, they can use dietdoctor.com. It is a website created by doctors. As far as exercise. It is very difficult to fit in exercise in today's day. We are all workaholics and we have very hectic work schedules. A lot of people have to manage a home, taking care of the kids, sending them to school
And so instead of having to go to a gym, there are many methods to do exercise at home. There's a lot of free content on YouTube. I do even tell sometimes my kids and teenagers too practice a TikTok dance. There are many phone apps with free content and you can always subscribe and get some paid versions and you do get what you pay for, so you can always invest in yourself and get more ideas for exercise. You can get a gym membership and, of course, go safely. And you can also get very affordable workout gear. Sometimes at the $5 store, you can get weights, you can get jump rope, resistance bands or yoga mats. As long as it's something that you enjoy doing, I think that's all that matters.
Host: Most definitely. Your health is definitely your greatest asset, so make sure you're taking care of yourself. And If you are just needing that extra support, give your primary care provider a call. They're here. They're very knowledgeable. They want to help you and they can maybe give you some additional information that you maybe haven't seen somewhere else.
So thank you so much for joining me today, Dr. Baig. And thank you so much for tuning in to the Well Within Reach podcast. To learn more about this topic and various topics we have, our website is RiversideHealthcare.org.